DENTAL CARE IN CRITICALLY ILL PATIENTS: THE EXPERIENCE OF A MULTIDISCIPLINARY TEAM

Abstract

Objective To describe dental procedures performed in critically ill patients of a hospital in São Paulo, Brazil. Study Design Digital files were retrieved from patients evaluated by our dental team (consisting of oral medicine, prosthodontics, and oral surgery specialists) over a twelve-month period. Results This study evaluated 121 patients (from May 2021 to April 2022), of whom 83 (68.6%) were male and 38 (31.4%) were female, with a mean age of 64 years (range: 24-98). Most patients were under mechanical ventilation (n=82, 67.8%). Forty-eight patients (39.7%) had a diagnosis of COVID-19 and 11 (9.1%) were recovering from the disease. Oral hygiene was the most frequent procedure (n=81, 66.9%), followed by photobiomodulation (n=34, 28.1), mainly to treat viral infections or traumatic lesions. Oral hygiene using a suction toothbrush/swab and chlorhexidine 0.12% mouthwash was performed by a dentist daily to reduce ventilation-associated pneumonia (VAP). It was also performed by the nursing staff three times a day. Custom-made mouth opening devices were performed in 6 cases (9.6% of intubated patients) to prevent tongue injuries or airway flow obstruction. Conclusion oral care is crucial in critically ill patients, and a multidisciplinary team can help to provide specialized care in this complex and highly-demanding population. To describe dental procedures performed in critically ill patients of a hospital in São Paulo, Brazil. Digital files were retrieved from patients evaluated by our dental team (consisting of oral medicine, prosthodontics, and oral surgery specialists) over a twelve-month period. This study evaluated 121 patients (from May 2021 to April 2022), of whom 83 (68.6%) were male and 38 (31.4%) were female, with a mean age of 64 years (range: 24-98). Most patients were under mechanical ventilation (n=82, 67.8%). Forty-eight patients (39.7%) had a diagnosis of COVID-19 and 11 (9.1%) were recovering from the disease. Oral hygiene was the most frequent procedure (n=81, 66.9%), followed by photobiomodulation (n=34, 28.1), mainly to treat viral infections or traumatic lesions. Oral hygiene using a suction toothbrush/swab and chlorhexidine 0.12% mouthwash was performed by a dentist daily to reduce ventilation-associated pneumonia (VAP). It was also performed by the nursing staff three times a day. Custom-made mouth opening devices were performed in 6 cases (9.6% of intubated patients) to prevent tongue injuries or airway flow obstruction. oral care is crucial in critically ill patients, and a multidisciplinary team can help to provide specialized care in this complex and highly-demanding population.